second sls presentation from beth israel
DESCRIPTION
More data presented at SLS meeting in Boston Sept 2009TRANSCRIPT
Society of Laparoendoscopic Surgeons 2009
Prospective Evaluation of Endoscopic Plication and Reduction of Gastric Pouch in Patients who Previously Underwent Gastric
Bypass Surgery
Prospective Evaluation of Endoscopic Plication and Reduction of Gastric Pouch in Patients who Previously Underwent Gastric
Bypass Surgery
Chiranjiv S Virk MD, Dimitrios V. Avgerinos, MD, Radha Patel, Burton Surick, MD, John L. Holup, DO, Elliot R. Goodman, MD and I. Michael Leitman, MD
Department of Surgery
Beth Israel Medical Center
New York, NY
Chiranjiv S Virk MD, Dimitrios V. Avgerinos, MD, Radha Patel, Burton Surick, MD, John L. Holup, DO, Elliot R. Goodman, MD and I. Michael Leitman, MD
Department of Surgery
Beth Israel Medical Center
New York, NY
Society of Laparoendoscopic Surgeons 2009
Commercial Disclosures:Commercial Disclosures:
StomaphyX ® is a product of EndoGastric Solutions ®(Redmond, WA).
None of the authors have any financial relationship with EndoGastric Solutions ®.
StomaphyX ® is a product of EndoGastric Solutions ®(Redmond, WA).
None of the authors have any financial relationship with EndoGastric Solutions ®.
Society of Laparoendoscopic Surgeons 2009
Results (N=64)Results (N=64)
Age (years) 47.5 (24-66)
Female / Male 92% female / 8% male
Height (inches) 65
Median BMI Pre-Gastric Bypass 48.7
Median BMI Post-Gastric Bypass (nadir)
31.3
Median BMI Post-GB(nadir) 31.3
Median time(years) after Gastric bypass surgery
5 (2-10)
Society of Laparoendoscopic Surgeons 2009
Median BMI before StomaphyX
39.85 (25.9-54.9)
Median BMI post Stomaphyx
37.75(25.1-55.2)
Median follow up(months)
6(1-13)
No. Patients Weight loss
43(67%)
No. Patients no weight loss
14(21%)
No follow up weight available
7(12%)
Society of Laparoendoscopic Surgeons 2009
Median weight loss (lbs.) post StomaphyX
15.5(3.3-67)
Median OR time 50 (35-130)
Median reduction in gastric pouch length
33%(0-67)
Median # of fasteners
23(10-40)
Society of Laparoendoscopic Surgeons 2009
RESULTSRESULTS
Dumping syndrome improved
GERD improved
Dumping syndrome improved
GERD improved0
5
10
15
20
25
30
35
40
Pre-op Post-op
Dumping
GERD
Society of Laparoendoscopic Surgeons 2009
Endoluminal Gastric Pouch Reduction
Endoluminal Gastric Pouch Reduction
3 patients underwent repeat procedure due to unsatisfactory results.
Maximum weight loss: 67 lbsPostprandial diarrhea/GERD resolved.
Slowed gastric emptyingObliteration of the gastrocolic reflexNew valve created just distal to GE junction
3 patients underwent repeat procedure due to unsatisfactory results.
Maximum weight loss: 67 lbsPostprandial diarrhea/GERD resolved.
Slowed gastric emptyingObliteration of the gastrocolic reflexNew valve created just distal to GE junction
Society of Laparoendoscopic Surgeons 2009
Endoluminal Gastric Pouch Reduction
Endoluminal Gastric Pouch Reduction
Mechanism of Weight loss
Reduce size of gastric pouch
Possible to reduce size of stoma
Reduce compliance in the gastric pouch
Slows gastric emptying
Mechanism of Weight loss
Reduce size of gastric pouch
Possible to reduce size of stoma
Reduce compliance in the gastric pouch
Slows gastric emptying
Society of Laparoendoscopic Surgeons 2009
Endoluminal Gastric Pouch Reduction
Endoluminal Gastric Pouch Reduction
Pre anastomosis Post anastomosis
Society of Laparoendoscopic Surgeons 2009
Endoluminal Gastric Pouch Reduction
Endoluminal Gastric Pouch Reduction
Gastro-esophageal junction and gastric pouch
Society of Laparoendoscopic Surgeons 2009
Lessons LearnedLessons Learned
Reduce anastomotic diameterGross pouch dilation difficult to
completely remediateDumping and GERD symptoms do
improve.Double fastener techniqueWeight loss is modestProcedure is safe.
Reduce anastomotic diameterGross pouch dilation difficult to
completely remediateDumping and GERD symptoms do
improve.Double fastener techniqueWeight loss is modestProcedure is safe.
